Labor and Delivery Characteristics by Detailed Maternal Nativity Across the Black Diaspora: Place and Method of Delivery

Objective: This study aimed to examine the associations between detailed maternal nativity (DMN) and two labor and delivery (L&D) characteristics among US-born, Latin American and Caribbean-born, and SSA-born Black women in the US. L&D characteristics included the place of delivery (i.e., hospital, birthing center, or home) and the method of delivery (i.e., vaginal or cesarean).

Methods: Using Natality data, the authors examined the associations between detailed maternal nativity (DMN) and two L&D characteristics among US-born, Latin American and Caribbean-born, and SSA-born Black women in the USA who had a live delivery between 2016 and 2020 (N = 2,041,880). The main predictor was DMN (i.e., maternal country of birth) and the outcomes of interest were the place of delivery and the method of delivery. Associations were evaluated using multivariate multinominal and multivariate logistic regression models.

Results: Findings indicated that foreign-born Black women overall had decreased odds of delivering in birthing centers or at home, except for Ghanaian-born women who had increased odds of having an unintended home delivery. All Latin American and Caribbean-born and most SSA-born women had increased odds of delivering via cesarean.

Conclusions: The findings underscore the importance of considering DMN in exploring L&D characteristics. Specifically, increased odds of cesarean delivery among Latin American and Caribbean-born women highlight a potential area for interventions. Further research is warranted to understand the underlying factors driving the observed differences and the diverse needs of the growing population of foreign-born Black women in the US, and to develop effective strategies to promote equitable and optimal birthing experiences for all.